HomeMy WebLinkAboutApplication - 115 CRICKET LANE 7/25/2007 BUILDING PERMIT OF "'O oT" qti
TOWN OF NORTH ANDOVER 0?
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
�9SSAylo 4��
Date Issued:
IMPORTANT:Applicant must complete all items on this page
_.S F E
All L CATION �
S ICSI' I "Y�YV` 4w.l �,,,s a7r. d .�
z
�:..
MAID ter ,��,,,�;PARC�L% 3����C�Iti1�101���TRtC�' ��` � s�H�stc�r�c��strlct � 'F}des ncr
TYPE OF IMPROVEMENT PROPOSED USE
Resjodential Non- Residential
❑ New Building rf One family
�ddition ❑ Two or more family ❑ Industrial
❑ Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑ Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
❑Septic_ `LI 11SC�I���z � ` `.i���Flt�odplalrr YL��1Netl��tds�y � � tt��t�rshed Dtstr��t
„y.
DESCRIPTION OF WORK TO BE PREFORMED:
7- 26,r- h
J J�pnMc i Vse,T�v-�or Print gc�learly)
OWNER: Name: fm� N Phone: 97S°IoSb— 8foNS
Address:
a y
73 :.� t S *� ^�r� 'r i. �., z�s$<✓'� k _ .rL�,s �'< s� t<�rJ f 1 c r
1� t
f
� s
v � �c f'z�'*€'` �'� ��sue` ���,. P }� .t ; -s'. r � r # y 7 ,<„ � - a•,� ��,�.. r.��
�������I�C3F.:tt�✓�l us�U�i���� i; ]/��� .Y. ����_, .�� �-� � �����..�f�t�L € ��i;s s� s.��� -
ARCH ITECT/ENGINEER_ Phone:
Address: ���A�/�1 j A�, �,�/� f s Reg. No.
FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F.
Total Project Cost: $ F d 4 d FEE: $
Check No.: Receipt No.:
NOTE: Persons contracti ith unregistered.contractors do not have access to th aranty fu d
Signature;of A"ant/�wt��r� . . .� ;
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
COMMENTS
TE REJECTED DATE APPROVED
CONSERVATI Ow l?
.�-
COMMENTS Od' ' 04 0 (W' 10� OVS r WA21 76� M�W N18CG
140Fy W
DATE REJECTED �DAT OVE
HEALTH ❑
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/Signature&Date Driveway Permit
Located at 384 Osgood Street
FIRS R0*10 MENT ` � flurnster oh SJt� y5 t1U
v
F 3
101" IUIE IT
3 1